Alicia Bultsma, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901005482 Issued in MI

Practice address

2908 Division St
Saint Joseph, MI 49085-2437

Phone

(269) 983-3309

Fax

(269) 983-0846

NPI assigned

May 13, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Saint Joseph Vision Therapy LLC

  • Vision Therapy Optometrist
  • Saint Joseph, MI
  • NPI 1669937926
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1652400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1992442792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 S MAIN AVE",
            "city": "PLATTE",
            "state": "SD",
            "postal_code": "573692129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2908 DIVISION ST",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852437",
            "telephone_number": "269-983-3309",
            "fax_number": "269-983-0846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULTSMA",
        "first_name": "ALICIA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-13",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Marie Browning, LCSW
• Coty Buchwalter, DO
• Kimberly Renee Budner, PA-C
• Ather M Bukhari, MD
• Anneke Bulthuis, D.O.
• Erin Renee Burchett, DO
• James R Burczak, D.O.
• Nicole Lynn Burgess, PT
• Cathleen A Burns, MA, CCC-A
• Kamelia Burrell-Fowler, FNP

• Optometrist in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.